The Lead Episode 15: A Discussion of Incidence and Management of Atrioventricular Conduction Disorders in a New-Onset Left Bundle Branch Block after TAVI: A Prospective Multi Center Study-Heart Rhythm Journal

Heart Rhythm Journal

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A new study has investigated the incidence and management of atrioventricular (AV) conduction disorders in patients who develop left bundle branch block (LBBB) following transcatheter aortic valve implantation (TAVI). The researchers conducted a prospective multicenter study, including 183 TAVI recipients with new-onset LBBB. They assessed the incidence of AV block in this population and evaluated the performance and safety of a risk stratification algorithm based on electrophysiology study (EPS) followed by the implantation of a pacemaker or implantable loop recorder (ILR). The study found that 30.6% of patients developed a high-grade AV conduction disorder at 12 months. Patients with an HV interval (a measurement used in EPS) of less than 70 milliseconds were more likely to have high-grade AV conduction disorders. The study also found that the risk stratification algorithm provided valuable guidance in management decisions and was a reliable guide for pacemaker implantation. The researchers concluded that new-onset LBBB after TAVI is associated with high rates of high-grade AV conduction disturbances, and the risk stratification algorithm can help guide management decisions and provide reliable guidance for pacemaker implantation in these patients.

Keywords

AV conduction disorders

left bundle branch block

transcatheter aortic valve implantation

TAVI

incidence

management

prospective multicenter study

risk stratification algorithm

electrophysiology study

pacemaker implantation